7. CARER INVOLVEMENT IN PLANNING, SHAPING AND DELIVERY OF SERVICES AND SUPPORT
The purpose of this chapter is to set out how carers will be further involved in the planning, shaping and delivery of services and support. Their involvement is crucial to ensure the best quality services and support, delivered in a personalised way. Carers should be involved in a number of different ways.
7.1 Community Health Partnerships ( CHPs), established by NHS Boards, have a role in delivering the change required to support the cared-for person and the carer. This is because they have to ensure that people and communities are engaged in the decisions made on health services which affect them.
7.2 CHPs provide an opportunity for partners to work together to improve the lives of local communities. CHPs should actively involve the public, patients and carers.
7.3 Some CHPs have carer representation on them, through carer organisations. Carers themselves are represented on Public Partnership Forums, which are one of the main links between communities and CHPs. Members of the Public Partnership Forums (usually Chairs and/or Vice-Chairs) generally have a place on the local CHP, and a number of carers currently fulfil this function.
The Scottish Government believes there should be carer representation on CHPs and will ensure that this happens.
7.4 Public Partnership Forums continue to provide a valuable input into the planning and delivery of local services and it is important that their role continues to evolve. As such, the Scottish Government will be undertaking a review of Public Partnership Forums so that their role can be strengthened and developed. Given the important contribution that carers make to Public Partnership Forums through their expertise and knowledge, we are committed to involving them in the review so that their interests are fully represented.
ACTION POINT 7.1
In 2010-11, the Scottish Government will ensure carer representation on CHPs by writing to the Chief Executives of Health Boards to make this happen.
ACTION POINT 7.2
In 2010-11, in taking forward a review of Public Partnership Forums, the Scottish Government will ensure that it consults with appropriate carer organisations in order that their interests are fully represented.
ACTION POINT 7.3
Local authorities and NHS Boards will ensure they fully involve the national carer organisations, other Third Sector organisations and carers, as appropriate in the planning and shaping of services and support.
7.5 Carers will continue to be involved in inspections of services when the new scrutiny bodies, Social Care and Social Work Improvement Scotland ( SCSWIS) and Healthcare Improvement Scotland ( HIS), are set up in 2011.
7.6 The Healthcare Quality Strategy for NHSScotland, published in May 2010 21, will also help ensure the voice of carers is heard. It is the key driver for further change and improvements in healthcare. This strategy will seek to ensure that healthcare is of the highest quality, with improved safety and clinical effectiveness based on person-centred support and the full involvement of care partners. There will be an emphasis on developing relationship-based care and shared decision-making. A further aim is to ensure that patients and carers have clear instructions and information on care, treatment and symptoms and that they are fully involved in treatment choices. There will be a clear emphasis on treating carers as equal and expert partners with knowledge and experience, especially about the person they care for.
7.7 The Healthcare Quality Strategy lists National Quality Outcome Measures, some of which are of direct relevance to carers and older young carers and which help ensure carers have a pivotal role in decision-making. In particular:
- Carers will provide feedback on their experiences of healthcare. The Scottish Government is considering how to capture the experiences of carers; and
- The measure on emergency admissions, relating to supporting patients to remain at home, will reflect improved partnership working with carers.
7.8 Carer involvement and participation in procurement processes is essential to empower carers, and to ensure that services properly take account of carers' needs.
7.9 The Scottish Government expects to report on the consultation on Draft Guidance on Social Care Procurement in summer 2010. The Draft Guidance sets out a framework for social care procurement in Scotland which has a significant impact on people's quality of life and well-being.
7.10 Local authorities' commissioning strategies should set out the future response to meeting needs and improving outcomes and the plans for major shifts, such as moving control from organisations to individuals and moving from institutional/buildings-based services to community support, where that is appropriate.
7.11 Local authorities should adopt an inclusive approach and create an environment which involves stakeholders, including service users, their advocates, carers, service providers and those with a statutory responsibility for service delivery, working together to improve outcomes for service users and carers.
7.12 Procurement processes have, in some cases, given service users and carers a sense that they have little control over their lives and no ability to impact on the decisions made in respect of their services.
7.13 The involvement of service users and carers, and the opportunity for them to voice their experiences and views, is essential at every main stage of the procurement process, from the earliest stages of analysis and planning to the later stages of contract monitoring, management and review. Service users and their carers may have an opinion on changes to current service provision, may have concerns about an existing provider which merit a change of provider, or may want to support the continuation of a service provided by the local authority or voluntary or private sector.
ACTION POINT 7.4
In 2010 and beyond, the Scottish Government and COSLA will promote the Social Care Procurement Guidance to local authorities so that they are aware of that part of the guidance on carer participation and can act on it as appropriate. Furthermore, the Scottish Government will provide training for procurement staff, establish learning networks and promote good practice to continue to seek improvement in procurement practices across Scotland, which will take account of the need to involve carers.
7.14 Carers should be involved, as appropriate, in the care plans for the people they care for. For example, with regard to carers who care for people with mental health problems, psychiatric services need to ensure that they involve the carer as much as possible in the care and treatment plan so that the carer can be fully supported and engaged. This can be a difficult area for all concerned if the adult refuses to give consent to share personal information with carers, as is their legal right. In these circumstances, professionals must respect the need for professional confidentiality, whilst maintaining an open professional relationship with carers as interested parties.